Tackle That Shoulder Pain

Build up your shoulders evenly—and protect against trouble—by working your rotator cuff as much as your delts

As a shoulder surgeon, I see the same scenario play out over and over again. It goes something like this: A guy in his thirties joins a gym to get in shape. He starts working out on his own or with a personal trainer. In short order, he walks through my door with shoulder pain.

There are few things more deflating in life than sinking time and money into a gym membership and all you have to show for it is shoulder pain that keeps you up at night. If this sounds familiar, don’t become discouraged—you are not alone and the treatment is pretty straightforward. If this is not you, it might be in the near future, so pay attention. A better understanding of the shoulder and how to properly train it might keep you out of offices like mine.

Usually the problem is something called impingement syndrome, which is simply another name for bursitis and tendinitis of the rotator cuff. It commonly affects people in their 30’s and 40’s and causes pain on the outside of the shoulder, particularly at night. Here’s how the shoulder works: The deltoid tries to pull the shoulder up, and the rotator cuff keeps it down in order to keep the shoulder centered so that the arm can be lifted. The deltoid and the rotator cuff are antagonists—that is, they perform actions that are opposite of each other. When the deltoid gets stronger than the rotator cuff, the shoulder starts to migrate up and pinches the rotator cuff and surrounding bursa between the shoulder and the bone on the top of the shoulder. This causes inflammation and pain. This pinching is why we call it impingement syndrome.